WEDNESDAY, Sept. 8 (HealthDay News) -- A group representing America's pediatricians is urging that flu shots be mandatory for all U.S. health-care workers in order to protect patients.

While many organizations have used voluntary programs in an effort to improve coverage, flu vaccination rates among health-care workers remain unacceptably low, said the members of the Committee on Infectious Diseases at the American Academy of Pediatrics.

"Mandatory influenza immunization for all health-care personnel is ethically justified, necessary, and long overdue to ensure patient safety," they wrote in the AAP policy statement, which will appear in the October issue of the journal Pediatrics.

Immunization rates of 80% or higher are needed to achieve the "herd immunity" required to have a major impact of flu transmission by health-care workers, but current rates of flu vaccination for this group remain near 40%, the authors said.

They noted that mandatory immunization for health-care workers is not unusual. For example, many medical facilities require specific vaccines and a tuberculin skin test as conditions of employment or to be allowed to work in specific areas of an institution.

Medical and religious exemptions to mandatory flu vaccination can be granted on an individual basis, the statement authors suggested.

They offered a number of examples of the effectiveness of mandatory flu vaccination policies. The Virginia Mason Medical Center in Seattle achieved a 99% compliance rate after it made influenza vaccination mandatory in 2005. The compliance rate was 100% after the U.S. National Institutes of Health Clinical Center made flu vaccination mandatory for employees who had contact with patients.

Flu outbreaks are a common and serious public health problem. Each year in the United States, influenza causes more than 36,000 deaths and 200,000 hospitalizations and costs the country $87 billion, according to the AAP statement.